Index-Guided High-Power Radiofrequency Catheter Ablation for Atrial Fibrillation: A Systematic Review and Meta-Analysis Study

Waranugraha, Yoga; Tsai, Chia-Ti; Lin, Lian-Yu

doi:10.1007/s11886-023-01968-6

Cited by 1 publication

(2 citation statements)

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“…3,22 The trim-and-fill method was used to confirm the existence of publication bias. 9 The new scoring system was developed based on the pooled HR of strong predictors from the meta-analysis. The presence of exit and entry blocks confirmed the complete PVI.…”

Section: Data Extractionmentioning

confidence: 99%

“…Electrical isolation of the PVs, or PVs isolation (PVI), is the cornerstone of AF ablation. [6][7][8][9] The point-by-point radiofrequency catheter ablation (RFCA) approach is technically more complicated and requires the electroanatomic mapping system reconstruction of the left atrium (LA) and PVs. On the other hand, with only a few energy applications, cryoballoon catheter ablation (CBCA) creates a complete circumferential lesion around the PVs.…”

Section: Introductionmentioning

confidence: 99%

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Novel scoring system derived from meta‐analysis and validated in cohort population for predicting 1‐year atrial fibrillation recurrence after cryoballoon catheter ablation: The HeLPS‐Cryo score

Waranugraha,

Hsu,

Lin

et al. 2024

Pacing Clinical Electrophis

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BackgroundAtrial fibrillation (AF) recurrence rates in 1 year after cryoballoon ablation catheter (CBCA) are still high. We purposed to identify strong predictors for AF recurrence after the successful CBCA procedure and develop a new scoring system based only on pre‐procedural parameters.MethodsIn the derivation phase, a systematic review and meta‐analysis identified the strong predictors of AF recurrence after the CBCA. The pooled hazard ratio (HR) was used to create the new scoring system. The second phase validated the new scoring system in the cohort population.ResultsA meta‐analysis including 29 cohort studies with 16196 participants confirmed that persistent AF, stroke, heart failure, and left atrial diameter (LAD) >40 mm were powerful predictors for AF recurrence after the CBCA procedure. The HeLPS‐Cryo (heart failure [1], left atrial dilatation [1], persistent AF [2], and stroke [2]) was developed based on those pre‐procedural predictors. It was validated in 140 patients receiving CBCA procedures and revealed excellent predictive performance for 1‐year AF recurrence (AUC = 0.8877; 95% CI = 0.8208 to 0.9546). The HeLPS‐Cryo score of ≥3 could predict 1‐year AF recurrence with sensitivity and specificity of 78.9% and 87.9%, respectively. The positive predictive value was 66.7%, and the negative predictive value was 93.1%.ConclusionThe HeLPS‐Cryo score can help the physician estimate the probability of 1‐year AF recurrence after the successful CBCA procedure. Patients with HeLPS‐Cryo score <3 are good candidates for the CBCA procedure.

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Section: Data Extractionmentioning

confidence: 99%